Disparities in Health Care Utilization by Race Among Teenagers and Young Adults With Muscular Dystrophy

Bibliographic Data

ID9103933
AuthorsOrgul D Ozturk (0000-0001-8446-0271, University of South Carolina, corresponding author), Suzanne McDermott (0000-0003-1517-5033, University of South Carolina), Joshua R Mann (0000-0002-3716-3642, University of South Carolina), James W Hardin (0000-0003-0506-5500, University of South Carolina), Julie A Royer (0000-0001-5323-1986), Lijing Ouyang (0000-0002-9309-7627, Centers for Disease Control and Prevention)
Year2014
Volume52
IssueSupplement 3
PagesS32-S39
Publication date2014-10-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000000194
PMID25215918
OpenAlexW2328911696
LanguageEN
Citations received3
References cited18

BACKGROUND: For people with muscular dystrophy (MD) health care access is crucial and utilization is expected to be high. A multidisciplinary approach is needed for optimal management of symptoms of this rare condition. Regular primary care, specialty care, therapy, and medicine use can improve quality of care and reduce need for emergency treatment and hospitalization. We analyzed health insurance and administrative data to test for racial disparities in regular care use among teenagers and young adults with MD. METHODS: We used South Carolina Medicaid and other administrative data for individuals aged 15-24 years to determine annual health care utilization patterns for individuals with MD by race. We studied adolescents and young adults with MD because this age group represents a time when the condition is typically intensifying and the transition from pediatric to adult care is expected. We used Generalized Estimating Equation models to analyze longitudinal utilization data conditional on other factors that may lead to utilization differences. RESULTS: Race is correlated with health care utilization among adolescents and young adults with MD. Blacks have lower overall utilization, and less primary care, therapy, and specialist care use but higher incidence of hospitalization and emergency treatment use compared with whites and also to other races. The most striking disparity was the use of outpatient services. Blacks utilized these services 50% less compared with whites and 70% less compared with others. Even in regression analysis, where we take into account individual unobserved factors and allow clustering at the individual level, these differences remained and were in most cases statistically significant. CONCLUSIONS: Our results indicate that there are differences in health care utilization by race even when individuals have access to the same health care benefits. This means simply offering coverage to individuals with MD may not be sufficient in eliminating health disparities. Future studies will be needed to examine other possible sources of these racial disparities, such as resource awareness, health knowledge, or access barriers such as transportation

Health care · Health equity · Muscular dystrophy · Political science · Public health · Race (biology) · Sociology · Adolescent and Pediatric Healthcare · Internal Medicine · Medicine · Muscle Physiology and Disorders · Neurogenetic and Muscular Disorders Research · Nursing · Psychology · Gerontology · Pediatrics

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